Long ago (1988) I moved to Berkeley and started sending a monthly "newsletter" to my Boston friends. When I returned to Boston (1993), I continued the tradition for about five more years (or until I had kids). Looking back, I realize that I was actually blogging. Each newsletter contained anywhere from a few to several blog posts. Having been silent for the past decade or so, I've decided to resume these activities. Don't expect anything profound -- I tend to focus on what I find entertaining or amusing and perhaps sometimes informative. We shall see!

Tuesday, July 26, 2011

Why Healthcare Costs are Ridiculous

Twice a year I take my son to see two doctors in one appointment at one of the premier children's hospital in the country. He has been seeing these doctors for approximately ten years. During that time our health insurance has never changed. We book these appointments approximately three months in advance. So, this should all be simple, right?

We arrive for our 9:30 appointment at about 9:25. I immediately put our name on the sign-in sheet. We start getting signed in at 9:43. For one of the two doctors, they can accept any form of payment; for the other, they can accept only cash or check. OK, I have cash. The co-pay is $15; I have both twenty dollar bills and five dollar bills. I say that I can pay cash, but will need either a five or a ten for change. Without batting an eyelash, the woman checking me in says, "I don't have any cash." Unable to stifle it, I laugh. Fortunately, she sees the humor.

[Interrupt: it is 9:53 as I type this -- we overhear one of the administrators say, "Right now, everyone is rolling along right on schedule." Um, in what universe is it the case that at appointment time+23 we've not yet been called into the office "on schedule"?]

Back to our story: She proceeds to check me in with the one doctor for whom we can use any form of payment. This entails approximately five sheets of paper and seven sticky labels, not including the credit card receipt and the receipt that she printed for me. Oh yeah, did I mention that this hospital actually has all its medical records online? I kid you not -- in the doctor's office, everything is online and we can pull up any old visit or test done at this hospital (at any of the hospital's three facilities that we use regularly).

Now we get to deal with doctor number 2 who can only accept cash or check. I have pleasantly left $25 on the counter, dying of curiousity to see how they are going to deal with this, since it is so not my problemTM. Once again, the woman checking me in says, "I have no cash." Another parent checking in, however, has change for a twenty. Whew. Disaster averted. She changes my twenty, I pay then in ten ones and a five (to give them a nice variety of change for future clients). Now we get a hand written receipt, in duplicate using carbon receipt paper (honest!), another seven sticky labels, carefully affixed to various pieces of paper, and at 9:51 we are fully checked in.

Is it any wonder that the system is inefficient? What a collossal waste. It's now 10:04 (we got called in for height, weight, blood pressure check; my son is now officially taller than I am). We are in the doctor's office and I'm guessing by 10:15 we'll see doctors -- a full 45 minutes after our designated time. Once here, the two doctors will work like a well-oiled machine. Seriously, they are efficient, friendly, informative and treat us well -- I like and respect these folks, but why can't the rest of the process work as smoothly as they do?